Nicholas Jay Moore, MD - Medicare Sports Medicine in Novi, MI

Nicholas Jay Moore, MD is a medicare enrolled "Family Medicine - Sports Medicine" physician in Novi, Michigan. He went to Medical College Of Wisconsin and graduated in 2011 and has 13 years of diverse experience with area of expertise as Sports Medicine. He is a member of the group practice Ascension Providence Hospital and his current practice location is 26850 Providence Pkwy Ste 260, Novi, Michigan. You can reach out to his office (for appointments etc.) via phone at (248) 465-5140.

Nicholas Jay Moore is licensed to practice in Michigan (license number 4301108292) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1265727556.

Contact Information

Nicholas Jay Moore, MD
26850 Providence Pkwy Ste 260,
Novi, MI 48374-1256
(248) 465-5140
(248) 465-5141



Physician's Profile

Full NameNicholas Jay Moore
GenderMale
SpecialitySports Medicine
Experience13 Years
Location26850 Providence Pkwy Ste 260, Novi, Michigan
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Nicholas Jay Moore attended and graduated from Medical College Of Wisconsin in 2011
  NPI Data:
  • NPI Number: 1265727556
  • Provider Enumeration Date: 06/14/2011
  • Last Update Date: 04/16/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 1658687041
  • Enrollment ID: I20150831001949

Medical Identifiers

Medical identifiers for Nicholas Jay Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1265727556NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 4301108292 (Michigan)Secondary
207QS0010XFamily Medicine - Sports Medicine 4301108292 (Michigan)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Ascension Providence Hospital, Southfield And NoviSouthfield, MIHospital
Huron Valley-sinai HospitalCommerce township, MIHospital
Ascension St John HospitalDetroit, MIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Ascension Providence Hospital6103738703181

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Nicholas Jay Moore allows following entities to bill medicare on his behalf.
Entity NameAscension Providence Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942265236
PECOS PAC ID: 6103738703
Enrollment ID: O20031103000326

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Entity NameVhs Physicians Of Michigan
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073827101
PECOS PAC ID: 8921289760
Enrollment ID: O20110225000849

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicholas Jay Moore is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Nicholas Jay Moore, MD
26850 Providence Pkwy Ste 260,
Novi, MI 48374-1256

Ph: (248) 465-5140
Nicholas Jay Moore, MD
26850 Providence Pkwy Ste 260,
Novi, MI 48374-1256

Ph: (248) 465-5140

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PDI third quarter revenues increase 4% to $37.2 million

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Family Medicine Doctors in Novi, MI

Robert A Carter, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 26850 Providence Pkwy, Suite 375, Novi, MI 48374
Phone: 248-662-4200    Fax: 248-662-0368
Victoria Nicole Dooley, M.D.
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 21580 Novi Rd, Ste 200, Novi, MI 48375
Phone: 248-946-4905    
Thomas Joseph Anan, MD
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 25691 Strath Haven Dr, Novi, MI 48374
Phone: 586-256-4170    Fax: 248-465-4901
Michael Balon, M.D.
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 26850 Providence Pkwy, Suite 370, Novi, MI 48374
Phone: 248-465-4160    Fax: 248-465-4525
Moneer Al-nabolsi,
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 44130 W 12 Mile Rd, Novi, MI 48377
Phone: 248-380-8811    
Dr. Jeffrey Joshowitz, D.O.
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 39475 Lewis Dr, Suite 140, Novi, MI 48377
Phone: 248-489-0766    Fax: 248-489-0788
Dr. Bilal Tarek Malek, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 39555 Orchard Hill Pl Ste 600, Novi, MI 48375
Phone: 248-621-4581    Fax: 248-621-4582

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